OPHTE# Harnett County Department of Public Health 24874
PERMIT # Operation Permit
New Installation �k Septic Tank�Nitrification Line ❑ Repair ❑ Expansior
Q PROPERTY LOCATION: NGQ.-1N (iAA9velt_ 1-1)
Name: (owner) SQ�Gc:GL.A�PRSL`/ `,�tr-s,pq SUBDIVISION `tJtA%TE'raNr- LOT # L -)—
System Installer. t=,,j 63 Syvt % c— Registration #
Basement with plumbing ❑ Garage ❑ Number of Bedrooms j
Type of Water Supply: ❑ Community ❑ Public V Well Distance from well 100 feet
System Type: Types V and VI Systems expire in 5 years.
(In accordance with Table V a) Owner must contact Health Department 6 months prior to expiration for permit renewal.
This system has been installed 0 compliance wills applicable North Carolina General Statutes,_ Rules for Sewage Treatment and Disposal, and all conditions of the Improvement Permit and construction Authorization
PERMIT CONDITIONS
I. Performance: System shall perform in accordance with Rule .1961.
11. Monitoring: As required by Rule .1961.
III. Maintenance: As required by Rule .1961. Other.
Subsurface system operator required? Yes ❑ No
If yes, see attached sheet for additional operation conditions, maintenance and reporting.
IV. Operation:
V. Other.
❑
D -Box
❑ Pump ❑ Alarm ❑
H2OLine ❑ PWR Line
Following are the
specifications for
the sewage disposal system on the captioned prop
Type of system:
❑ Conventional
Bpove
)4 Other C.MameBa l(\o c.3( t1 -t Septic Tank SCp
gallons Pump Tank gallons
Subsurface
No. of
exact length width of
depth of
Drainage Field
ditches
of each ditch ��' 0 feet ditches .3
feet ditches , 1 inches
French Drain Required: \
Linear feet
Authorized State Agent R(a''Y Date to -11)
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